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CArdiac STereotactic Radiation Treatment for Ablation of ventRicular Tachycardia (CASTAR)

5. november 2026 opdateret af: Cancer Research Antwerp

The investigator-initiated, CArdiac Stereotactic radiation Treatment for Ablation of ventRicular tachycardia (CASTAR) study will be conducted in patients with ventricular tachycardia (VT) which is either refractory to antiarrhythmic medication therapy in maximal dose or to catheter ablation or with contraindications to antiarrhythmic medication or catheter ablation.

The study is a non-randomized, multicenter, interventional study of cardiac SBRT, for which a total dose of 25 Gy will be delivered in a single fraction using volumetric modulated arc therapy (VMAT). The aim of the CASTAR study is to assess the feasibility and the safety of cardiac SBRT for the treatment of VT. Secondary objectives are efficacy, toxicity and QoL of cardiac SBRT for Ventricular tachycardia .

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The study will be conducted at multiple centers across Belgium. Twenty patients will be enrolled to the study. Interim analyses are planned to be performed when the first five or ten subjects have been treated. Participation in the study will comprise a screening period, where screening assessments must be completed before starting treatment. Eligible, consenting patients will then undergo SBRT, which is limited to a single dose delivery on one day. During SBRT, patients are closely monitored in accordance with the DEGRO guidelines for radiotherapy in patients with ICDs (Gauter-Fleckenstein 2015). After SBRT, patients will be closely monitored during a 3-5 days hospitalization. The post-treatment phase will start after patients are discharged from the hospital. Patients will be followed on regular basis to assess safety and efficacy of SBRT treatment.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

20

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Belgien
    • Belgium
      • Antwerp, Belgium, Belgien, 2610
        • Rekruttering
        • ZAS Augustinus
        • Kontakt:
        • Ledende efterforsker:
          • Ines Joye, PhD
      • Edegem, Belgium, Belgien, 2600
        • Rekruttering
        • UZA
        • Kontakt:
        • Ledende efterforsker:
          • Johan Saenen, PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Patients over the age of 18 with structural heart disease
  • Patients with ventricular tachycardia requiring intervention (e.g. an electrical shock or anti-tachycardia pacing via an Implantable Cardioverter Defibrillator (ICD)) which cannot be managed with medication or catheter ablation, or where there are contraindications to treatment with medication or catheter ablation.
  • Contraindications may exist due to comorbidities or due to the type or severity of the disease.
  • Informed consent to participate has been obtained from the patient or from his or her legal representative.

Exclusion Criteria:

  • Lack of evidence that the ventricular tachycardia is triggered by myocardial scarring (based on MRI, CT EAM).
  • Any contraindication to radiosurgery (e.g. inability to precisely define the target volume due to imaging artefacts caused by an LVAD)
  • Pregnancy
  • Previous radiotherapy that prevents the safe delivery of the dose.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: SBRT

A single radiation dose of 25 Gy is delivered to the VT target.
Stråling: Stereotactic body radiation therapy (SBRT)

Stereotactic body radiation therapy (SBRT): a single radiation dose of 25 Gy is delivered to the VT target.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Feasibility of SBRT for the treatment of ventricular tachycardia
Tidsramme: Day of SBRT treatment (Day 1)

Feasibility will be assessed as the successful implementation and completion of cardiac SBRT without interruption of treatment. SBRT consists of a single fraction of 25 Gy delivered to the ventricular tachycardia target.
Day of SBRT treatment (Day 1)
Safety of SBRT for the treatment of ventricular tachycardia.
Tidsramme: From SBRT treatment through 31 days after SBRT

Safety will be assessed by the incidence and severity of adverse events related to radiotherapy following cardiac SBRT. Adverse events will be assessed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 5.0.
From SBRT treatment through 31 days after SBRT

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in ventricular tachycardia burden following SBRT
Tidsramme: 6 months before SBRT through 6 months after SBRT

The ventricular tachycardia (VT) burden will be assessed by the number of VT episodes recorded by ECG and implantable cardioverter-defibrillator (ICD) readouts. The number of VT episodes during the 6 months following SBRT will be compared with the number during the 6 months preceding SBRT. A 6-week blanking period immediately following SBRT will be taken into account in the analysis of VT recurrences.
6 months before SBRT through 6 months after SBRT
Time from SBRT to first VT recurrence
Tidsramme: From SBRT through 36 months after treatment

Time from SBRT treatment to the first documented recurrence of ventricular tachycardia, as determined from ICD readouts. A 6-week blanking period following SBRT will be considered in the analysis of VT recurrence.
From SBRT through 36 months after treatment
Time from SBRT to first sustained ventricular tachycardia or ICD shock
Tidsramme: From SBRT through 36 months after treatment

Time from SBRT treatment to the first occurrence of sustained ventricular tachycardia or the first appropriate ICD shock during follow-up.
From SBRT through 36 months after treatment
Time from SBRT to first ventricular tachycardia storm
Tidsramme: From SBRT through 36 months after treatment

Time from SBRT treatment to the first occurrence of a ventricular tachycardia storm during follow-up.
From SBRT through 36 months after treatment
Change in the number of electrical storms following SBRT
Tidsramme: 6 months before SBRT through 6 months after SBRT

The number of electrical storms occurring following SBRT will be compared with the number occurring before SBRT treatment.
6 months before SBRT through 6 months after SBRT
Change in anti-tachycardia pacing and ICD shocks following SBRT
Tidsramme: 6 months before SBRT through 6 months after SBRT

The number of anti-tachycardia pacing (ATP) interventions and ICD shocks following SBRT will be compared with the number occurring before SBRT treatment.
6 months before SBRT through 6 months after SBRT
Change in anti-arrhythmic medication use following SBRT
Tidsramme: From baseline through 36 months after SBRT

Anti-arrhythmic medication use will be assessed during follow-up. The type and dosage of anti-arrhythmic drugs will be collected to evaluate changes in the need for anti-arrhythmic treatment following SBRT.
From baseline through 36 months after SBRT
Overall survival following SBRT
Tidsramme: From SBRT through 36 months after treatment

Overall survival will be assessed from the date of SBRT treatment until death from any cause.
From SBRT through 36 months after treatment
Incidence of heart transplantation following SBRT
Tidsramme: From SBRT through 36 months after treatment

The number and proportion of participants requiring heart transplantation during follow-up will be assessed.
From SBRT through 36 months after treatment
Incidence of cardiac arrhythmic mortality following SBRT
Tidsramme: From SBRT through 36 months after treatment

The number and proportion of participants who die from a cardiac arrhythmic cause during follow-up will be assessed.
From SBRT through 36 months after treatment
Incidence of cardiac non-arrhythmic mortality following SBRT
Tidsramme: From SBRT through 36 months after treatment

The number and proportion of participants who die from a cardiac non-arrhythmic cause during follow-up will be assessed.
From SBRT through 36 months after treatment
Incidence and severity of acute radiation-related adverse events
Tidsramme: Through 90 days after SBRT

The incidence and severity of adverse events related to radiotherapy will be assessed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 5.0. Acute adverse events are defined according to the time period specified in the protocol.
Through 90 days after SBRT
Incidence and severity of late radiation-related adverse events
Tidsramme: The protocol defines late adverse events as those occurring more than 90 days after starting radiotherapy.

The incidence and severity of late adverse events related to radiotherapy will be assessed and graded according to NCI CTCAE version 5.0.
The protocol defines late adverse events as those occurring more than 90 days after starting radiotherapy.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Cancer Research Antwerp

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

25. februar 2026

Primær færdiggørelse (Anslået)

25. februar 2032

Studieafslutning (Anslået)

25. februar 2035

Datoer for studieregistrering

Først indsendt

20. oktober 2026

Først indsendt, der opfyldte QC-kriterier

5. november 2026

Først opslået (Faktiske)

12. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

5. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CTO22012GZA

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